America is (perhaps) the most developed country in the world, in many regards. But there is a spot on its claim as the world’s garden of Eden, the lack of a national healthcare system. To someone who comes from Europe, and lives in Taiwan, this is a remarkable omission. It is amazing to believe that nearly 50 million people in the USA have no healthcare cover at all. Let’s not forget to include the under-insured as well. The statistics are shocking, to any one with any sensibility.
Taiwan experimented with employer-based insurance for quite sometime, but eventually introduced its own national scheme in 1995. Since then, coverage is approximately 98% of the population. Even expanded access to the very poor, veterans and aboriginals was provided. While Taiwan’s health care system is still new, still problematic, one of the fears was put to rest: its cost to Taiwan. For a modest increase of 1% of GDP, an additional 41% of the population gained access to medical care which previously would have been prohibitively expensive. More importantly, though, the percentage of GDP is considerably less than the United States.
So, in the United States, medical insurance largely depends on one’s private wealth, occupation or the government programs. For the first category, serious illness can devastate your wealth; for the second, unemployment (or even employment) can leave you without any cover – or affordable cover; and there are two programs for the very poor. But the reality is that many people who earn decent salaries can barely afford healthcare as it is. For those that can afford cover, there are a number of organisations that provide, if your employer doesn’t.
There are, however, many ways to buy private insurance, Blue Cross Blue Shield NC, a member of the Blue Cross Blue Shield Association, provides insurance to residents of North Carolina resident who are under 65 years of age and are not qualifying for Medicare. Together, national, the BCBSA provides insurance for approximately 100 million Americans through its associated companies (some of which are non-profit). This is one example of the different ways you can buy health insurance. Of course, if the companies are for-profit, then you may find coverage is less complete than you would assume or that premiums would be higher or some combination for both. Insurance companies are seeking to make a profit so that they can remain in business, and provide a return on investment for those who were willing to take the risk to start the companies in the first place. Who can blame them? After all, here is business trying to make up for a clear lack of direction and leadership on the government’s part.
While there is much wrong with the American system of healthcare, especially when 16% of GDP goes on healthcare costs, one of the bright spots is that you are able to choose your healthcare provider(s). But for the most part, I can’t see why a country will spend so much money on defense, arms procurement, NASA programs, and yet continually ignore the health needs for a large part (and not necessarily poor) of their population. 40% of them actually earn $50K pa or more, yet health care is unaffordable or prohibitively expensive. IMHO, the government should exercise a leadership role in organising the care its people get, if at least making sure that everyone has access to basic care. Of course, that is a European perspective.
But then the UK established its national health care in 1948. And, yes, we still have private insurance, too, for those who want it. Yes, there are problems with our healthcare system and waiting lists, but the costs are considerable lower for broadly similar results and life expectancy. Wake up, America. You may be the land of the free, but many of those who are free are paying the price with their health.